States Call Out Big Businesses with Employees on Medicaid

The recent push by state lawmakers to publicly shame large corporations that have employees enrolled in Medicaid is a long-overdue reckoning with the complex web of corporate welfare and public subsidies that underpin our economy. California Democrats are reviving an expired law that would require companies employing 100 or more people with Medicaid enrollees to be publicly named.

This effort is not just about fairness; it’s also a matter of basic economic logic. Taxpayers deserve to know how their hard-earned dollars are being spent on healthcare costs for low-wage workers. Companies like Walmart and Amazon, which have significant presences in Nevada, raise questions about the adequacy of these companies’ health benefits offerings.

The narratives around Medicaid abuse often get tangled up in partisan politics, with accusations of insurer fraud and abuse flying back and forth between state Democrats and the Trump administration. Meanwhile, state lawmakers are pushing back by highlighting the role of big employers that don’t offer affordable health benefits, leaving taxpayers to pick up the tab for their low-wage workforce.

A Tale of Two Policies

The proposed California bill is part of a broader trend of states seeking to hold large corporations accountable for their healthcare costs. In Nevada, companies like Amazon and Walmart have been among the largest employers on the state’s Medicaid rolls, with thousands of employees enrolled in 2025. The fact that these companies are pushing back against reports, arguing that they’ve included part-time and seasonal employees, only highlights the lack of transparency and accountability in this system.

In contrast to Nevada’s law, which simply requires public disclosure, some states have considered financial penalties for companies with Medicaid-enrolled employees. New Jersey Gov. Mikie Sherrill signed a bill in June to fine businesses that have at least 50 Medicaid-enrolled employees. This approach raises questions about the efficacy of penalizing corporations rather than addressing the root causes of healthcare affordability and access.

The Work Requirements Conundrum

The looming deadline for states to enforce new work requirements is a critical moment in this debate. Under HR 1, nondisabled Medicaid enrollees ages 19-64 in most states will have to prove they are working, volunteering, or going to school at least 80 hours a month to keep their coverage. This provision is projected to increase the number of uninsured people nationwide by more than 5 million by 2034, according to the Congressional Budget Office.

The Employer Responsibility Gap

Health policy researchers argue that employer Medicaid reports highlight the lack of affordable healthcare options available to low-wage workers. More than half of adults enrolled in Medicaid who don’t have dependent children already meet the 80-hour-a-month requirement or face challenges that would likely qualify them for an exemption. This creates a perverse incentive for employers to shift their healthcare costs onto taxpayers rather than offering decent benefits to their employees.

A Fundamental Rethink

The push by state lawmakers to publicly shame large corporations with Medicaid-enrolled employees is just one aspect of the ongoing debate about corporate welfare and public subsidies. As we examine this complex web, it’s essential to remember that the root causes of healthcare affordability and access lie in our economic policies, not just our healthcare system.

While some may argue that penalizing corporations is a step in the right direction, others will point out that this approach only addresses symptoms rather than addressing the underlying issues. As we move forward, one thing is clear: the status quo is unsustainable, and it’s time for policymakers to consider more radical solutions, like increasing the federal minimum wage or implementing stricter regulations on employer-sponsored insurance.

The people are watching, and it’s time for action. The Medicaid-employers nexus is just one thread in the intricate web of corporate welfare and public subsidies. It’s time for policymakers to take a hard look at the economic policies driving this system and consider fundamental changes to ensure that everyone has access to decent healthcare.